Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms.
COVID-19
Disease outbreaks
Droplet and contact precautions
Healthcare-associated COVID-19
Infection prevention and control
Isolation on site
SARS-CoV-2
Secondary attack rate
Shared rooms
Whole-genome sequencing
Journal
Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411
Informations de publication
Date de publication:
06 Jul 2024
06 Jul 2024
Historique:
received:
18
12
2023
accepted:
28
06
2024
medline:
7
7
2024
pubmed:
7
7
2024
entrez:
6
7
2024
Statut:
epublish
Résumé
The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site. This observational study was performed at the University Hospital Basel, Switzerland, from 03/20 - 11/20. Secondary attack rates were compared between patients hospitalized in multiple-bed rooms and exposed to individuals subjected to on-site isolation precautions (on-site isolation group), and patients exposed to individuals initially not identified as having COVID-19, and not placed under isolation precautions until the diagnosis was suspected (control group). Transmission events were confirmed by whole-genome sequencing. Among 1,218 patients with suspected COVID-19, 67 (5.5%) tested positive for SARS-CoV-2. Of these, 21 were isolated on-site potentially exposing 27 patients sharing the same room. Median contact time was 12 h (interquartile range 7-18 h). SARS-CoV-2 transmission was identified in none of the patients in the on-site isolation group vs. 10/63 (15.9%) in the control group (p = 0.03). Isolation on-site of suspected COVID-19-patients in multiple-bed rooms avoided single-room occupancy and subsequent in-hospital relocation for many patients without confirmed SARS-CoV-2-infection. The absence of secondary transmission among the exposed patients in the on-site isolation group allows for assessment of the risk/benefit ratio of this strategy given the limitation of a small sample size.
Identifiants
pubmed: 38971822
doi: 10.1186/s13756-024-01430-4
pii: 10.1186/s13756-024-01430-4
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
73Informations de copyright
© 2024. The Author(s).
Références
Castagna F, Xue X, Saeed O, Kataria R, Puius YA, Patel SR, et al. Hospital bed occupancy rate is an independent risk factor for COVID-19 inpatient mortality: a pandemic epicentre cohort study. BMJ Open. 2022;12:e058171.
doi: 10.1136/bmjopen-2021-058171
pubmed: 35168984
Li R, Rivers C, Tan Q, Murray MB, Toner E, Lipsitch M. Estimated demand for US Hospital Inpatient and Intensive Care Unit beds for patients with COVID-19 based on comparisons with Wuhan and Guangzhou, China. JAMA Netw Open. 2020;3:e208297.
doi: 10.1001/jamanetworkopen.2020.8297
pubmed: 32374400
pmcid: 7203604
Winkelmann J, Webb E, Williams GA, Hernández-Quevedo C, Maier CB, Panteli D. European countries’ responses in ensuring sufficient physical infrastructure and workforce capacity during the first COVID-19 wave. Health Policy. 2022;126:362–72.
doi: 10.1016/j.healthpol.2021.06.015
pubmed: 34311982
Stadler RN, Maurer L, Aguilar-Bultet L, Franzeck F, Ruchti C, Kühl R, et al. Systematic screening on admission for SARS-CoV-2 to detect asymptomatic infections. Antimicrob Resist Infect Control. 2021;10:44.
doi: 10.1186/s13756-021-00912-z
pubmed: 33640031
pmcid: 7912536
Leuzinger K, Gosert R, Søgaard KK, Naegele K, Bielicki J, Roloff T, et al. Epidemiology and precision of SARS-CoV-2 detection following lockdown and relaxation measures. J Med Virol. 2021;93:2374–84.
doi: 10.1002/jmv.26731
pubmed: 33314153
Leuzinger K, Roloff T, Gosert R, Sogaard K, Naegele K, Rentsch K, et al. Epidemiology of severe Acute Respiratory Syndrome Coronavirus 2 emergence amidst community-acquired respiratory viruses. J Infect Dis. 2020;222:1270–9.
doi: 10.1093/infdis/jiaa464
pubmed: 32726441
Stange M, Mari A, Roloff T, Seth-Smith HM, Schweitzer M, Brunner M, et al. SARS-CoV-2 outbreak in a tri-national urban area is dominated by a B.1 lineage variant linked to a mass gathering event. PLoS Pathog. 2021;17:e1009374.
doi: 10.1371/journal.ppat.1009374
pubmed: 33740028
pmcid: 8011817
Gao R, Zu W, Liu Y, Li J, Li Z, Wen Y, et al. Quasispecies of SARS-CoV-2 revealed by single nucleotide polymorphisms (SNPs) analysis. Virulence. 2021;12:1209–26.
doi: 10.1080/21505594.2021.1911477
pubmed: 34030593
pmcid: 8158041
Birrer M, Perrig M, Hobi F, Gfeller C, Atkinson A, Egger M, et al. Droplet precautions on-site (DroPS) during the influenza season 2018/2019: a possible alternative to single room isolation for respiratory viral infections. Antimicrob Resist Infect Control. 2022;11:2.
doi: 10.1186/s13756-021-01038-y
pubmed: 35000584
pmcid: 8743058
Sommerstein R, Castro Lopes Azevedo T, Aerschmann C, Hobi F, Egger M, Marschall J. Droplet precautions on site instead of single room isolation for respiratory tract infections. Infect Control Hosp Epidemiol. 2019;40:939–42.
doi: 10.1017/ice.2019.142
pubmed: 31169479
World Health Organization. Recommendations for national SARS-CoV-2 testing strategies and diagnostic capacities: interim guidance. 2021. https://www.who.int/publications/i/item/WHO-2019-nCoV-lab-testing-2021.1-eng . Accessed 21 Sept 2021.
Fung HF, Martinez L, Alarid-Escudero F, Salomon JA, Studdert DM, Andrews JR, et al. The Household secondary attack rate of severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Rapid Review. Clin Infect Dis. 2021;73:S138–45.
doi: 10.1093/cid/ciaa1558
pubmed: 33045075
Wolfensberger A, Kufner V, Zaheri M, Zeeb M, Nortes I, Schreiber PW, et al. Nosocomial COVID-19 incidence and secondary attack rates among patients of Tertiary Care Center, Zurich, Switzerland. Emerg Infect Dis. 2022;28:2087–90.
doi: 10.3201/eid2810.220321
pubmed: 36048771
pmcid: 9514341
Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. J Heart Lung Transpl. 2020;39:405–7.
doi: 10.1016/j.healun.2020.03.012
Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020;382:2081–90.
doi: 10.1056/NEJMoa2008457
pubmed: 32329971
Puhach O, Meyer B, Eckerle I. SARS-CoV-2 viral load and shedding kinetics. Nat Rev Microbiol. 2023;21:147–61.
pubmed: 36460930
von Rotz M, Kuehl R, Durovic A, Zingg S, Apitz A, Wegner F, et al. A systematic outbreak investigation of SARS-CoV-2 transmission clusters in a tertiary academic care center. Antimicrob Resist Infect Control. 2023;12:38.
doi: 10.1186/s13756-023-01242-y
Carabelli AM, Peacock TP, Thorne LG, Harvey WT, Hughes J, Peacock SJ, et al. SARS-CoV-2 variant biology: immune escape, transmission and fitness. Nat Rev Microbiol. 2023;21:162–77.
pubmed: 36653446
pmcid: 9847462
Han MS, Byun JH, Cho Y, Rim JH. RT-PCR for SARS-CoV-2: quantitative versus qualitative. Lancet Infect Dis. 2021;21:165.
doi: 10.1016/S1473-3099(20)30424-2
pubmed: 32445709